目的 分析深圳市宝安区近16年新发职业病的发病特征与趋势,为职业病精准防控提供参考依据.方法 通过"中国疾病预防控制信息系统"导出深圳市宝安区2006年1月至2021年12月共16年的职业病资料,对病例的基本情况,人群分布、企业分布进行统计描述,并对主要病种的变化趋势进行分析.结果 深圳市宝安区近16年间共报告8大类38种共884例新发职业病病例,不同年份职业病报告情况明显不同(x2=678.374,P＜0.01).2015年以前发病例数波动式上升,2015年后呈波动式下降.报告病例数前三是职业性耳鼻喉口腔疾病(均是职业性噪声聋)、职业性化学中毒、尘肺病和其他呼吸系统疾病,分别占总数的37.6％,25.2％和15.2％.职业病病例发病年龄中位数为39岁,发病工龄中位数为6年.制造业报告的病例最多,占总数的93.7％.私营企业和港澳台独资企业报告的病例分别占总数的40.4％和31.1％.小型企业和中型企业报告的病例数分别占总数的42.5％和28.2％.结论 深圳市宝安区的职业病谱发生了显著改变,应提高对噪声危害的重视程度,增加对私营企业、港澳台企业职业病防治的宣传,加强对中小企业职业病防治的技术支持和监督管理.

我国职业健康监管职能在卫生、劳动以及安全生产监管部门之间历经多次调整,监管体制呈现从集中统一到多头负责,再到集中统一的历史轨迹[1-3].近年来,全国人大常委会先后4次(2011、2016、2017和2018年)修改《职业病防治法》,对涉及部门监管职责、行政审批制度改革、用人单位责任和劳动者切身利益等重大事项作出调整.

Objective: To compare the ophthalmic examination indices of different occupational groups in Shenzhen and analyze the possible health problems, so as to provide research basis for further health intervention. Methods: In March 2021, 5426 professionals with ophthalmic examination index data were selected from the basic health database of "Shenzhen occupational population protection action". Among them, radiation workers (694), port operators (1756), sanitation workers (946), teachers (224), video workers (154), police (927) and firefighters (100) were selected as the investigated occupational population. They were exposed to noise 625 workers with traditional occupational hazards such as noise, chemical poisons and dust were used as the control population.Ophthalmic examination indices included right eye vision, left eye vision, outer eye, conjunctiva, cornea, lens, and fundus oculi. The differences of each index in different occupational groups were compared. Results: Compared with the control group, the port operator group showed lower abnormal rates of binocular vision and fundus oculi (P<0.05), but higher abnormal rates of conjunctiva (P=0.029), the environmental sanitation worker group showed higher abnormal rates of binocular vision and conjunctiva (all P<0.01), the teacher group had higher abnormal rates of binocular vision, but only the difference of left eye vision was statistically significant (P=0.021), and the video worker group had higher abnormal rates of right and left eyes vision (P=0.029、0.006) . Conclusion: There were some degrees of ophthalmic problems in different occupational population, therefore targeted intervention measures should be taken according to the characteristics of each group.

Objective: To understand the current situation and influencing factors of cervical and lumbar spine diseases of the express delivery employees, and provide scientific basis for carrying out their occupational health protection in a targeted manner. Methods: From February 2020 to January 2021, the current situation research method was used to obtain 527 express delivery employees by cluster sampling. Online questionnaires were used to investigate sociodemographic characteristics and emotional characteristics, and clinical data were obtained by digital X-ray (DR) examination of the neck and waist. Pearson χ(2) test and multivariate logistic regression were used to analyze the influencing factors of cervical and lumbar spine diseases in express delivery employees. Results: The prevalence rates of cervical spine and lumbar spine diseases among express delivery employees were 49.15% (259/527) and 67.74% (357/527) , respectively. Univariate analysis showed that there were statistically significant differences in the distribution of cervical and lumbar spine disease among express delivery employees with different ages, length of service, working hours per week, and different degrees of distress due to emotional factors (P<0.05) . Multivariate analysis showed that express delivery employees aged ≥25 years old had a higher risk of cervical spine disease (P<0.05) , the express delivery employees who worked 49-55 hours per week had a lower risk of cervical spine disease (P<0.05) . Express delivery employees aged≥35 years old had a lower risk of lumbar spine disease (P<0.05) , and the risk of lumbar spine disease was higher among express delivery workers who suffered moderate or more distress due to emotional factors (such as anxiety, depression, or irritability) in the past 4 weeks (P<0.05) . Conclusion: The prevalence of cervical and lumbar spine diseases is relatively high among express delivery employees. It is recommended to adjust the weekly working hours of express delivery employees, organize psychological counseling training, and effectively protect the occupational health rights of express delivery employees.

Objective: To understand the occurrence of occupational injuries among sanitation workers in Shenzhen, and provide a scientific basis for the prevention of occupational injuries among sanitation workers. Methods: From May to November 2020, a cluster sampling method was used to select some street sanitation workers in Shenzhen to conduct a questionnaire survey. A total of 2200 questionnaires were recovered, of which 2167 were valid (98.5% effective recovery rate) . The socio-demographic data, length of service, type of work and occurrence of occupational injuries of sanitation workers were collected, and the distribution characteristics of occupational injuries and their relationship with factors such as type of work were analyzed. Results: Among the 2167 sanitation workers, 240 (11.1%) had experienced occupational injuries. The most common occupational injuries among sanitation workers were sharp injury, heat stroke and motor vehicle traffic accident, with the incidence rates of 6.1% (133/2167) , 2.4% (53/2167) and 1.7% (36/2167) respectively. There were statistically significant differences in the distribution of occupational injuries among sanitation workers with different lengths of work and types of work (P<0.05) . The incidence of occupational injury among sanitation workers with more than 5 years of service was significantly higher than that of workers with less than 5 years of service (P<0.05) . The incidence of sharp injury among garbage sorting and transportation personnel was higher (7.9%, 21/265) , the incidence of heat stroke among manual cleaners was higher (3.1%, 42/1366) , and the incidence of motor vehicle traffic accident among mechanized cleaners was higher (5.4%, 10/184) . Conclusion: There are many cases of occupational injuries among sanitation workers in Shenzhen. Targeted measures should be taken to prevent the occurrence of different types of work and different types of occupational injuries, and to improve the occupational health level of sanitation workers.

To understand the volatile organic components in the organic solvents used by enterprises in Baoan District, Shenzhen. From January to December 2020, a total of 541 organic solvent samples used by 86 companies were collected for volatile organic component analysis, and the main volatile components and high-risk occupational hazards in organic solvents used in different industries were analyzed. A total of 201 volatile organic components were detected in 541 organic solvents. The top 5 components detected include xylene (29.76%, 116/541), toluene (21.81%, 118/541), methanol (20.70%, 112/541), n-hexane (14.79%, 80/541) and ethylbenzene (14.23%, 77/541). The detection rates of benzene, trichloroethylene, n-hexane, and 1, 2-dichloroethane, which were high-risk occupational hazards, were 2.40% (13/541), 3.70% (20/541), 14.79% (80/541), and 1.66% (9/541), respectively. The volatile components in organic solvents used in different industries was different. Benzene is more frequently detected in organic solvents used in the printing industry, trichloroethylene was more frequently detected in organic solvents used in the electronics industry, and n-hexane was more commonly found in organic solvents used in the electronics industry, printing and other industries, and 1, 2-dichloroethane has been more frequently detected in organic solvents used in the machinery industry. There are many types of organic solvents used by enterprises in Bao'an District, with complex components and differences in different industries.

目的 分析深圳市近年来在慢性正己烷中毒发病情况与分布特征的基础上,开展工作场所中正己烷危害现状调查,为慢性正己烷中毒的防控提供依据.方法 对2013-2017年深圳市确诊的58例慢性正己烷中毒病例进行回顾性分析,并对病例集中分布的电子设备制造业的正己烷危害现状进行横断面调查.结果 2013-2017年深圳市报告的58例慢性正己烷中毒病例发病年龄中位数为28.0 (18.0～52.0)岁,正己烷接触时间中位数为7.0(3.0～64.0)月,均分布于中小企业的手工清洗、清洁岗位,其中群发病例46例,均来自电子设备制造业.对深圳市39家电子设备制造企业使用的53份清洗溶剂样品进行挥发性有机组分分析,其中26家企业的32份样品检出含有正己烷;122个正己烷接触岗位中118个岗位的正己烷CTWA(时间加权平均浓度)小于50％PC-TWA(时间加权平均容许浓度),1个岗位的正己烷CTWA超过PC-TWA.结论 正己烷作为清洗溶剂在深圳市电子设备制造业的使用非常广泛,应严格管控中小电子设备制造业含正己烷有机溶剂的使用,预防群体性慢性正己烷中毒的发生.

对某大型陶瓷企业作业场所进行职业卫生调查、职业卫生检测.该企业生产性粉尘以矽尘为主,11份粉尘样品游离二氧化硅含量为(21.02±15.93)％;现场矽尘检测64个点共280份样品,合格率为62.5％(样品合格率85.4％),排风罩控制点风速合格率为13.33％.该企业矽尘的超标原因主要为生产工艺落后、工艺布局不合理、防护设施不足等,应采取有针对性的措施控制矽尘危害.

Objective To analyze the characteristics of occupational hazards and protective effect in thin-film Integrated circuit industry, and provide the basis for the measures of prevention and control.Methods The occupational hazards and its degree, protective devices and its effects, were evaluated by conducting occupational health survey, identification and monitoring of chemical hazards.Results The industry produced high toxic substances such as phosphine, chlorine, ammonia, hydrogen fluoride, carbon monoxide and arsenic hydride. The concentrations of chemical hazards in the workplace met the requirements of occupational exposure limits. In addition to hydrogen peroxide in wafer cleaning and hydrogen chloride in furnace tube chemical vapor deposition, the contact concentration of chemical hazards in other posts was less than 10％ of the occupational exposure limit.Conclusion The chemical protection facilities and measures adopted by the industry can achieve better control effect and maintain the existing control measures. However, regular maintenance and management of chemical monitoring systems, fresh air handling, process equipment and accident exhaust system should be strengthened.

目的 了解电机制造企业不同车间噪声危害及频谱特征.方法 采用判断抽样法,以深圳市某电机制造企业为研究对象,对其15个生产车间共90个工作地点16～16 000 Hz范围内11个频段的噪声强度进行了测量,运用聚类分析对不同车间噪声频谱特征进行分析.结果 测试车间噪声最大,其次为一号跑车房、浸油房、空压机房、二号跑车房和大啤部,平均值都超过了90.00 dB(A).聚类分析结果显示,组装一车间、组装二车间、组装三车间、组装四车间、注塑车间、机加工车间、涂粉一车间及涂粉二车间的噪声频谱特征相似,低频噪声强度较大,噪声强度最高值出现在63 Hz,之后随着频率的增高噪声强度不断下降.二号跑车房、大啤部、烧焊车间和空压机房噪声频谱特征相似,以中间频段噪声强度为主,125～2 000 Hz之间的噪声强度较大,其他频段的噪声强度显著降低;一号跑车房、浸油房和测试车间噪声频谱特征相似,高频噪声强度较大,噪声强度随着频率的增高呈上升趋势,在8 000Hz达到最高,之后略有下降.结论 同一生产企业不同车间的噪声危害分布有其特征,应对噪声源做频谱分析,有助于找出防护重点并采取更为有效的防护措施.

通过现场职业卫生学调查和检测,收集深圳市65家企业职业卫生基础资料,从10方面60项指标结合企业规模进行统计分析.结果 显示,建设项目职业病防护设施“三同时”、工作场所中职业病危害因素浓(强)度、工作场所中职业病危害因素日常监测和定期检测、公告栏的设置、职业病防护设施、岗前或离岗职业健康检查等18项职业卫生指标符合率较低.工作场所管理、防护设施、教育培训、健康监护和应急管理5个方面,以及企业职业卫生基础建设的整体情况,与企业规模之间存在相关关系(P＜0.01).提示深圳市企业职业卫生整体形势严峻,应加强监管力度,落实企业职业卫生主体责任,并对企业实行量化分级管理,从而提高职业卫生整体水平.

Background: Both cigarette smoking and long-term exposure to crystalline silica dust were reported to be associated with increased mortality. However, the combined effect of both factors has not been well evaluated. Methods: We investigated a retro-prospective cohort of 7,665 workers from one Chinese iron mine with a median follow-up of 42.8 years. Cumulative silica exposure was estimated for each worker by linking work histories with a job-exposure matrix. Cigarette smoking information was collected through face-to-face questionnaires. Hazard ratios (HRs) for total and cause-specific mortality due to silica exposure and smoking were estimated using Cox proportional hazards models. Results: A total of 2,814 deaths occurred during 315,772.9 person-years of follow-up. Significantly elevated mortality from all causes, cardiovascular disease, non-malignant respiratory disease and lung cancer was observed among silica-exposed workers, while elevated mortality from non-malignant respiratory disease and lung cancer was observed among smokers. Combined exposure to silica dust and cigarette smoking elevated the proportion of mortality and accounted for 21.2, 76.0, 35.7 and 81.4% of all causes, non-malignant respiratory disease, cardiovascular disease, and lung cancer, respectively. Significant additive joint effects of silica exposure and cigarette smoking on mortality from lung cancer (HR 1.893, 95% CI 0.628 to 3.441) and pneumoconiosis (6.457, 0.725 to 39.114), together with a significant multiplicative joint effect from all causes (1.002, 1.000 to 1.004) were observed. Conclusions: The present findings indicated that silica exposure in combination with cigarette smoking accounted for a fraction of extra deaths in our cohort. Our research showed the urgent need for smoking cessation and silica control among iron miners.

目的 了解某钢结构工程公司职工的职业健康状况,为钢结构工程公司的职业病危害防控提供参考.方法 根据工种将员工分为电焊工组(n=145)和对照组(n=307),对两组人群2017年职业健康检查结果进行比较分析.结果 电焊工组与对照组相比,血常规淋巴细胞百分比率(32.59%vs.34.46%)及平均红细胞蛋白含量(330.61 g/L vs.334.52 g/L)明显降低(P<0.05),血常规中性粒细胞百分比率(59.59%vs.57.63%)、小气道异常检出率(20.00%vs.5.54%)及高频听阈损伤检出率(53.79%vs.26.38%)明显增高(P<0.05).电焊工组和对照组其他血常规指标、肝功能指标水平、尿常规各项目异常检出率、肺通气功能减退、心电图异常、血压异常、血糖异常、脂肪肝、胆囊息肉、胆管(胆囊)结石、鼓膜内陷、鼓膜穿孔、中耳炎检出率差异均无统计学意义(P>0.05).结论 电焊作业过程中产生的职业病危害会对电焊工心血管系统、呼吸系统及听力产生影响,应采取措施控制职业病危害,预防职业病.

通过对深圳市3家液晶显示器(LCD)制造企业开展职业卫生现场调查和职业病危害因素检测,应用半定量风险评估模型对其主要工作岗位的化学有害因素进行风险评估.结果显示,阵列车间、封装蒸镀车间和模组车间各岗位化学性有害因素的风险指数为2或1,属于低风险或可忽略风险.辅助工程靶材打磨岗位铟及其化合物与残材处理岗位其他粉尘的风险指数为3,属于中等风险.提示,该行业采取的防护设施与措施控制效果较好,应注意化学品储运、气体监测和工艺设备排风系统等防护设施的定期维护及维保人员呼吸防护与培训.

[目的]明确深圳市某垃圾发电厂存在的职业病危害因素及工人接触水平.[方法]采用查阅文献、现场调查,现场检测及实验室检测等方法.[结果]该垃圾发电厂主要职业病危害因素为二氧化碳、一氧化碳、二氧化硫、氨、硫化氢、氯化氢、粉尘、高温和噪声,检测结果显示灰渣处理岗位的粉尘浓度不符合职业接触限值的要求,粉尘作业级别为Ⅰ级(轻度危害作业).[结论]垃圾发电厂存在多种职业病危害因素,还需要采取更多措施控制灰渣处理等辅助岗位的职业病危害.

[目的]分析焊工作业中锰接触对作业人员血清免疫球蛋白和性激素的影响.[方法]2016年10月以某人防工程公司96名男性焊工为焊工组,同时选择96名男性非焊工人员作为对照组,以全自动生化仪检测两组人员的血清免疫球蛋白IgA、IgM、IgG水平,以石墨炉原子吸收法检测两组人员的尿锰水平;以化学发光免疫分析法检测促黄体生成激素(LH)、促卵泡生成激素(FSH)、睾酮(T)、黄体酮(P)、雌二醇(E2)和泌乳素(PRL),并对结果进行分析.[结果]焊工组尿锰水平为(1.59±0.67)μg/L,高于对照组的(0.45±0.08)μg/L,差异有统计学意义(P<0.01).焊工组的血清IgG、T和P水平低于对照组,FSH水平高于对照组,差异有统计学意义(P<0.05或0.01).焊工组的IgA与T水平呈负相关(r=-0.271,P<0.05),IgM和E2、尿锰,尿锰和FSH、PRL均呈正相关(r=0.209、0.220、0.487、0.250,P<0.01).[结论]电焊作业增加了锰接触的机会,可能会降低作业人员的免疫能力并影响其内分泌系统.

[目的]了解深圳市某金属制品企业的职业病危害现状,为深圳市金属制品行业职业卫生管理提供科学依据.[方法]采用职业卫生调查、职业卫生检测、职业健康检查和检查表分析法等方法进行分析评价.[结果]该企业的职业病危害因素包括化学毒物、粉尘、噪声、紫外辐射、手传振动和激光辐射.化学毒物、紫外辐射、手传振动和激光辐射的检测结果均符合国家标准.焊接岗位电焊烟尘检测合格率为76.9%.部分冲压、清洗、焊接和打磨岗位的噪声声级超标,噪声检测合格率为48.9%.职业病防护设施方面,打磨岗位和部分激光/机械手焊接岗位局部排风系统设计未达到要求.应急救援设施和措施方面,化学品仓库未设置事故排风、报警或检测装置,无冲淋洗眼设施,未配备急救人员,未定期组织职业病危害事故应急救援演练.总体布局、生产工艺及设备布局、辅助用室和职业卫生管理方面基本符合职业卫生有关规定.在岗期间职业健康检查率仅为5.9%,冲压岗位6人高频听力下降.[结论]金属制品企业存在的主要职业病危害因素是电焊烟尘和噪声,企业应加强相应的防护设施,提供有效的个人防护用品,开展职业健康监护,提升企业的职业病防治能力和水平.

Objective The aim of this study was to identify the occupational hazards existed in manufacturing process of the gold jewelry industry,provide the basis for developing prevention and control measures against occupational hazards,so as to reduce the occurrence of occupational diseases.Methods The field occupational health investigation was performed in eight gold jewelry-processing enterprises in Shenzhen city in 2015.The occupational hazards and degrees were evaluated by occupational hazards monitoring.Results Dust,N-heptane,n-hexane,chloroform,1,2-dichloroethane,benzene and any other chemical hazards and physical hazards (including noise and laser radiation) were observed in this industry.A total of 930employees exposed to occupational hazards in eight gold jewelry-processing enterprises,of which 371 people were exposed to dust,accounting for 39.9％,359 people were exposed to chemical poisons,accounting for 38.6％,191 people contacted noise,accounting for 20.5％,and 9 people contacted radiation,accounting for 1.0％.There were 266 occupational hazards detected and 262 qualified points with a pass rate of 98.5％.There were three dust spots (silica dust) and one noise exceeded the national occupational health standard.Conclusion Due to so many occupational hazards existing in the gold jewelryprocessing enterprises,it belongs to the project with serious occupational hazards.The employers should strengthen the management of occupational hazards to prevent occupational diseases.

目的 评估某油墨制造企业的职业病危害风险.方法 应用新加坡有害化学品职业暴露半定量风险评估方法对某油墨制造企业各岗位接触的职业病危害进行风险评估.结果 混料岗位矽尘和丙烯酸甲酯浓度超过职业接触限值,风险等级分别为高风险(4级)和中等风险(3级),其他职业病危害因素未超过职业接触限值,风险等级为低风险;研磨和产品检验岗位各种职业病危害因素均未超过职业接触限值,风险等级均为低风险或可以忽略的风险.结论 该油墨制造企业混料岗位风险较高,需要采取控制措施降低风险.

目的 了解深圳市某手机玻璃厂存在的职业危害及其程度.方法 在收集相关资料的基础上,采用职业卫生调查和现场检测等方法.结果 该厂存在多种职业病危害因素,其中丙酮、异佛尔酮、甲苯、乙苯、二甲苯、甲醇、正己烷、正庚烷、正戊烷、异戊烷、氟化物、其他粉尘、高温、噪声的合格率均为100％,甲醇合格率为91.7％.结论 该手机玻璃厂大部分职业病危害因素控制较好,但个别作业岗位甲醇浓度超过职业接触限值,职业病危害控制措施有待改进.